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Association of Subjective Well-Being, Symptoms, and Side Effects With Compliance After 12 Months of Treatment in Schizophrenia

J Clin Psychiatry 2007;68:75-80

Objective: Subjective well-being is considered important for compliance with antipsychotic treatment. The objective of this post hoc analysis of data from German patients in the Schizophrenia Outpatient Health Outcomes study was to investigate subjective well-being and compliance, with consideration of clinical symptoms and side effects, in outpatients diagnosedwith schizophrenia.

Method: In a multicenter observational study of 2960 patients with DSM-IV-defined schizophrenia recruited between January and December 2001, subjective well-being was measured during 12 months with the Subjective Well-Being Under Neuroleptic Treatment Scale, short version (SWN-K). Compliance was self- and physician-rated. The association of compliance with clinical parameters was assessed by logistic regression.

Results: Factor analysis resulted in 3 factors: SWN-K (r2= 0.867), clinical symptoms (r2 = 0.744), and side effects (r2= 0.420). The odds for being compliant were 1.363 times higher if the SWN-K score increased by 20 points. Changes in positive symptoms (OR = 0.773) and changes in extrapyramidal symptoms (OR = 0.830) were found to be associated with compliance.

Conclusion: Compliance with antipsychotic medication was strongly associated with subjective well-being; further factors were clinical symptoms and side effects.